Organization
KPU DENTAL LLC
Active
Other names
Milagro Dental
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KATARZYNA UJDA DDS (DENTIST OWNER)
(505) 982-9222
Entity
Organization
Contact information
Practice address
2019 GALISTEO ST STE L2, SANTA FE, NM 87505-2112
(505) 982-9222
(505) 982-7114
Mailing address
2019 GALISTEO ST STE L2, SANTA FE, NM 87505-2112
(505) 982-9222
(505) 982-7114
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DD3665
DENTAL LICENSE
NM
Enumeration date
08/11/2019
Last updated
08/11/2019
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